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Unrecognized pretransplant and donor‐derived cryptococcal disease in organ transplant recipients. Sun, HY Alexander, BD Lortholary, O Dromer, F Forrest, GN Lyon, GM Somani, J Gupta, KL Busto, R del Pruett, TL Sifri, CD Limaye, AP John, GT Klintmalm, GB Pursell, K Stosor, V Morris, MI Dowdy, LA Munoz, P Kalil, AC Garcia-Diaz, J Orloff, SL House, AA Houston, SH Wray, D Huprikar, S Johnson, LB Humar, A Razonable, RR Fisher, RA Husain, S Wagener, MM Singh, N Group, Cryptococcal Collaborative Transplant Study
dc.coverage.spatial United States 2011-06-21T17:27:22Z 2010-11-01
dc.description.abstract BACKGROUND: Cryptococcosis occurring ≤30 days after transplantation is an unusual event, and its characteristics are not known. METHODS: Patients included 175 solid-organ transplant (SOT) recipients with cryptococcosis in a multicenter cohort. Very early-onset and late-onset cryptococcosis were defined as disease occurring ≤30 days or >30 days after transplantation, respectively. RESULTS: Very early-onset disease developed in 9 (5%) of the 175 patients at a mean of 5.7 days after transplantation. Overall, 55.6% (5 of 9) of the patients with very early-onset disease versus 25.9% (43 of 166) of the patients with late-onset disease were liver transplant recipients (P = .05). Very early cases were more likely to present with disease at unusual locations, including transplanted allograft and surgical fossa/site infections (55.6% vs 7.2%; P < .001). Two very early cases with onset on day 1 after transplantation (in a liver transplant recipient with Cryptococcus isolated from the lung and a heart transplant recipient with fungemia) likely were the result of undetected pretransplant disease. An additional 5 cases involving the allograft or surgical sites were likely the result of donor&#x2010;acquired infection. CONCLUSIONS: A subset of SOT recipients with cryptococcosis present very early after transplantation with disease that appears to occur preferentially in liver transplant recipients and involves unusual sites, such as the transplanted organ or the surgical site. These patients may have unrecognized pretransplant or donor-derived cryptococcosis.
dc.language eng
dc.language.iso en_US
dc.publisher Oxford University Press (OUP)
dc.relation.ispartof Clin Infect Dis
dc.relation.isversionof 10.1086/656584
dc.subject Adult
dc.subject Aged
dc.subject Cohort Studies
dc.subject Cryptococcosis
dc.subject Cryptococcus
dc.subject Female
dc.subject Humans
dc.subject Male
dc.subject Middle Aged
dc.subject Postoperative Complications
dc.subject Time Factors
dc.subject Tissue Donors
dc.subject Transplants
dc.title Unrecognized pretransplant and donor‐derived cryptococcal disease in organ transplant recipients.
dc.type Journal article Alexander, BD|0071949
dc.description.version Version of Record 2010-11-1
duke.description.issue 9
duke.description.volume 51
dc.relation.journal Clinical Infectious Diseases
pubs.begin-page 1062
pubs.end-page 1069
pubs.issue 9
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group Medicine
pubs.organisational-group Medicine, Infectious Diseases
pubs.organisational-group Pathology
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 51
dc.identifier.eissn 1537-6591

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